New York State Workers’ Compensation Board Proposes New Medical Fee Schedule

June 8, 2018

The New York State Workers’ Compensation Board has released a proposed increase in medical reimbursement to providers who treat workers’ compensation patients.

The proposed medical fee schedule includes an overall fee increase for all provider types, as well as additional increases for certain specialty provider groups to potentially raise the number of authorized providers for injured workers. The proposed changes to the Medical Fee Schedule were published in the State Register on June 6, 2018. The Board will accept comments from the public for 60 days.

The proposal includes updated current procedural technology (CPT) codes, increased conversion factors and amended ground rules, which are available under the Medical Fee Schedules section on the Board’s website. Those who do not have access to CPT codes with descriptions can arrange to review them in person at Board offices.

“Access to quality medical care for injured workers is of utmost importance for a healthy workers’ compensation system,” Workers’ Compensation Board Chair Clarissa M. Rodriguez said in a New York State Workers’ Compensation Board press release. “The New York State workers’ compensation fee schedule has not changed substantially since 1996. These new fees will ensure providers in New York receive fair and reasonable reimbursement for prompt, quality treatment to our injured workers. This can also bring more providers into the system, another benefit to injured workers.”

The Board is also working to make other improvements to increase provider participation and injured workers’ access to quality medical care. This includes the adoption of a universal claim form to reduce paperwork in workers’ compensation claims, development of an online medical portal and a push to expand the types of providers authorized to treat injured workers.

The Board is encouraging the public, including injured workers, employers, self-insured employers, insurance carriers, third-party administrators, attorneys, medical providers and labor and business organizations to provide comments on the proposed changes to the medical fee schedule. Comments can be submitted on or before August 6, 2018. The Board will evaluate all comments received and will consider necessary revisions as the process advances.

Source: The New York State Workers’ Compensation Board

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